Time-varying effects of socio-demographic and economic factors on the use of institutional long-term care before dementia-related death : A Finnish register-based study

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Korhonen , A K , Einiö , E K , Leinonen , T , Tarkiainen , L H & Martikainen , P T 2018 , ' Time-varying effects of socio-demographic and economic factors on the use of institutional long-term care before dementia-related death : A Finnish register-based study ' , PLoS One , vol. 13 , no. 6 , e0199551 . https://doi.org/10.1371/journal.pone.0199551

Title: Time-varying effects of socio-demographic and economic factors on the use of institutional long-term care before dementia-related death : A Finnish register-based study
Author: Korhonen, Aino Kaarina; Einiö, Elina Kaisa; Leinonen, Taina; Tarkiainen, Lasse Hannes; Martikainen, Pekka Tapani
Contributor: University of Helsinki, Academic Disciplines of the Faculty of Social Sciences
University of Helsinki, Population Research Unit (PRU)
University of Helsinki, Academic Disciplines of the Faculty of Social Sciences
University of Helsinki, Population Research Unit (PRU)
Date: 2018-06-21
Language: eng
Number of pages: 16
Belongs to series: PLoS One
ISSN: 1932-6203
URI: http://hdl.handle.net/10138/239808
Abstract: Objectives: The effects of socio-demographic and economic factors on institutional long-term care (LTC) among people with dementia remain unclear. Inconsistent findings may relate to time varying effects of these factors as dementia progresses. To clarify the question, we estimated institutional LTC trajectories by age, marital status and household income in the eight years preceding dementia-related and non-dementia-related deaths. Methods: We assessed a population-representative sample of Finnish men and women for institutional LTC over an eight-year period before death. Deaths related to dementia and all other causes at the age of 70+ in 2001-2007 were identified from the Death Register. Dates in institutional LTC were obtained from national care registers. We calculated the average and time-varying marginal effects of age, marital status and household income on the estimated probability of institutional LTC use, employing repeated-measures logistic regression models with generalised estimating equations (GEE). Results: The effects of age, marital status and household income on institutional LTC varied across the time before death, and the patterns differed between dementia-related and non-dementia-related deaths. Among people who died of dementia, being of older age, non-married and having a lower income predicted a higher probability of institutional LTC only until three to four years before death, after which the differences diminished or disappeared. Among women in particular, the probability of institutional LTC was nearly equal across age, marital status and income groups in the last year before dementia-related death. Among those who died from non-dementia-related causes, in contrast, the differences widened until death. Conclusions: We show that individuals with dementia require intensive professional care at the end of life, regardless of their socio-demographic or economic resources. The results imply that the potential for extending community living for people with dementia is likely to be difficult through modification of their socio-demographic and economic environments.
Subject: 5141 Sociology
NURSING-HOME PLACEMENT
OLDER-PEOPLE
LIVING ARRANGEMENTS
ALZHEIMERS-DISEASE
INCIDENT DEMENTIA
RISK-FACTORS
FOLLOW-UP
PREDICTORS
PROXIMITY LIGATION
FINLAND
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